This master thesis will explore the interrelationship between humanitarian aid, politics, and conflict. Sri Lanka will be the geographic location for examination of relevant case studies, and theoretical literature review. The specific methodology will be a quantitative approach. For the purpose of this thesis, humanitarian aid will be defined as the establishment of a comprehensive healthcare system. The presented hypothesis is that there is a direct correlation between politics, conflict and the provision of appropriate humanitarian aid.
- Purpose and Background: According to the World Bank, the health sector represents a central pillar to the economy and infrastructure of Sri Lanka. March 27, 2013 the World Bank granted approval for supporting Sri Lanka’s efforts to improve the public health by approving a $200 million dollar loan. The magnitude of the project is expected to service a population exceeding 21 million individuals (The World Bank, 2013). Those with greatest susceptibility to health issues are those that are identified as economically vulnerable. There is an understood correlation between those reliant on public health services and susceptibility to communicable (tuberculosis, HIV/AID’s, etc.) and non-communicable diseases including heart disease, strokes, and hypertension (The World Bank, 2013). As such, there are two phases to an improved public health system. The first entails support for areas under the National Health Development plan. This first phase will address issues like maternal and child health, nutrition, the transmission of non-communicable diseases, and health system improvements. The second project phased addresses broad areas of innovation, results monitoring, and capacity-building (The World Bank, 2015).
- Thesis Statement:
Research question: What is the specific role that economics and policy development play in the social and health outcomes of the people of Sri Lanka?
Thesis Statement: Political action supporting the development of an improved public health system, will positively impact humanitarian aid, and other relevant social factors.
- Expanded thesis statement:
Point #1: Current political conditions and policies have shaped the present socio-economic landscape of Sri Lanka
Point #2: There are existent gaps between healthcare services/humanitarian aid for the middle class and wealthy citizens, comparative to the lower class. This creates conflict within the various caste and political groups.
Point #3: The government has acknowledged the far reaching socio-economic effect of a substandard healthcare system
Point #4: Investments and policy improvements in healthcare will have a multi-faceted socio-economic impact. Anticipated areas of improvement include education, social conditions, and health conditions including morbidity and mortality rates.
- Current political conditions and policies have shaped the present socio-economic landscape of Sri Lanka
- Major civil war and existent tension between the Sinhalese and Tamil minority has created ideological and ethnic mistrust. The violence and conflict ended in May 2009, after the government seized territory controlled by Tamil Tiger rebels. Moving forward healing and the building of trust must address accusations of abuse by both parties (BBC, 2015)
- The recent election that occurred on January 8th ended nine years of presidential rule by Mahinda Rajapaksa. Rajapaksa has been replaced by the former health minister (Maithripala Sirisena). 51.3 percent of the voters elected Mr. Sirisena to address issues like inflation, corruption, and to remove the Rajapaksa dynast. There was also concern by the Tamils, Muslims, and Christians of impending repression given the end of the civil war (economist.com, 2015).
- A world development report studies the impact of child nutritional status and school-age health problems, on school achievement in Sri Lanka. Results indicate that infrequent or sporadic infections or health issues may cause less learning disruption and effect on test scores than more persistent health issues. One interpretation of this data is that despite the work that Sri Lanka has done to enhance public education, children malnourished in early childhood and displaying school-age health problems exhibit lower academic performance. It is proposed that policy makers focus policies that provide opportunities to reduce the prevalence of malnutrition in early childhood (Wisniewski, 2010).
- There are existent gaps between current healthcare services/humanitarian aid for the middle class and wealthy citizens, comparative to the lower class.
- The Mahinda Chintana Goals (MCGs) for 2016 include eradication of hunger and hard core poverty, reducing malnutrition rate of children from a third to 12-15 percent (The Development Policy Framework Government of Sri Lanka, 2010).
- Other goals include increasing access to clean water in urban areas from 65 to 90 percent (The Development Policy Framework Government of Sri Lanka, 2010).
- The government has acknowledged the far reaching socio-economic effect of a substandard healthcare system
- Suicide in Sri Lanka is a significant public health issue. In 1995, Sri Lanka reported the highest suicide rate globally at (47 per 100, 000). In 2000, 60% of all self-harm admissions were aged 16-25. Of all the suicide deaths recorded, between 60-80% are caused by the ingestion of pesticides (Pearson, Zwi, & Buckley, 2010).
- Policy responses to the issue of suicide in Sri Lanka include the establishment of a Presidential Committee, legislative changes, and improved clinical management. The Presidential Committee (formed in 1996) developed a National Suicide Prevention Strategy in 1998 (Pearson, Zwi, & Buckley, 2010).
- Investments and policy improvements in healthcare will have a multi-faceted socio-economic impact. Anticipated areas of improvement include education, social conditions, and health conditions including morbidity and mortality rates.
- The National Health Development Plan (NHDP) aims to modernize the Health Management Information System (HMIS) in the country. This is aligned with Sri Lanka’s goal of becoming a “knowledge economy” leveraging e-governance and information and communication technologies (The World Bank, 2014).
- By the end of 2018 the goal is to have more than 80 percent of the state’s health facilities reporting in-patient information through an electronic recording system (The World Bank, 2014).
- Basic prehospital emergency medical care has been proven to reduce morbidity and mortality in injury and cardiovascular disease-related emergencies, while also being vital for planning and disaster response. Low-cost prehospital emergency medical care in developing and lower middle-income countries can have a significant effect on trauma mortality (Zimmerman, Bertermann, Bollinger, & Woodyard, 2013).
- The capacity of Sri Lanka to meet the needs of its expansive community requires a strategic multi-faceted approach.
- The principle focus should be on establishing a socio-political framework for meeting the needs of the people. At the highest level this could involves political changes in the administration of public health.
- Individuals that lack appropriate healthcare support due to (economics, and political conflict) have increased susceptibility to communicable and non-communicable diseases.
- Effective and transformative change in Sri-Lanka (i.e. clinics, hospitals, counseling centers) will require a network of available social resources. An appropriate network can help trauma/stress exposed persons from succumbing to adverse mental health consequences.
BBC. (2015, January 9). Sri Lanka profile. Retrieved from http://www.bbc.com/news/world-south-asia-11999611
Pearson, M., Zwi, A. B., & Buckley, N. A. (2010). Prospective policy analysis: how an epistemic community informed policymaking on intentional self poisoning in Sri Lanka. Health Research Policy and Systems, 8(19), 1-11. Retrieved from http://www.health-policy-systems.com/content/8/1/19
The Development Policy Framework Government of Sri Lanka. (2010). Retrieved from http://www.treasury.gov.lk/publications/mahindaChintanaVision-2010full-eng.pdf
The World Bank. (2013, March 27). World Bank provides US$200 million to further enhance the quality of the Health Sector Services in Sri Lanka. Retrieved from http://www.worldbank.org/en/news/press-release/2013/03/27/world-bank-provides-us200-million-further-enhance-quality-health-sector-services-sri-lanka
The World Bank. (2015). Projects and Operations. Retrieved from http://www.worldbank.org/projects/search?lang=en&searchTerm=&tab=map&countryshortname_exact=Sri%20Lanka
Wickrama, K., & Wickrama, T. (2010). Perceived community participation in tsunami recovery efforts and the mental health of tsunami-affected mothors: Findings from a study in rural Sri Lanka. International Journal of Social Psychiatry, 57(5), 518-527.
Wisniewski, S. L. (2010). Child Nutrition, Health Problems, and School Achievement in Sri Lanka. World Development, 38(3), 315-332.
Zimmerman, J. R., Bertermann, K. M., Bollinger, P. J., & Woodyard, D. R. (2013, October). Prehospital System Development in Jaffna, Sri Lanka. Prehospital and Disaster Medicine, 28(5), 509-516.
economist.com. (2015, January 17). Sri Lanka's Election_Ask Siri. Retrieved from http://www.economist.com/news/asia/21639559-new-president-promises-new-leaf-politics-ask-siri?zid=309&ah=80dcf288b8561b012f603b9fd9577f0e
worldbank.org. (2014, April 17). Upgraded Record Keeping Helps Save Lives in Sri Lanka. Retrieved from http://www.worldbank.org/en/news/feature/2014/04/17/upgraded-record-keeping-helps-save-lives